BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3844645 · Received June 3, 2014

    Report

    Report Number
    1525712-2014-02796
    Event Type
    Malfunction
    Date Received
    June 3, 2014
    Date of Event
    April 17, 2014
    Report Date
    April 18, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    TDXSP POWER WHEEL CHAIR WENT OUT ON END USER WHILE SHE WAS RIDING DOWN THE SIDEWALK. END USER WAS STRANDED AND HAD TO CONTACT A TAXI IN ORDER TO GET HOME. END USER REPORTED A 3 FLASH ERROR CODE TO THE DEALER WHEN INCIDENT OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    324767 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP

    Patients

    Seq Age Sex Outcome Treatment
    1 Other